Provider Demographics
NPI:1619571221
Name:SNIDER, WELLS JR
Entity Type:Individual
Prefix:
First Name:WELLS
Middle Name:
Last Name:SNIDER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 TECHNOLOGY DR STE 3310
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-8832
Mailing Address - Country:US
Mailing Address - Phone:304-292-2108
Mailing Address - Fax:304-292-3770
Practice Address - Street 1:1000 TECHNOLOGY DR STE 3310
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-8832
Practice Address - Country:US
Practice Address - Phone:304-292-2108
Practice Address - Fax:304-292-3770
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant